Statement On Television Violence
Before The U.S. House
Subcommittee On Telecommunications And Financeby Joycelyn Elders
Former U.S. Surgeon General

Committee on Energy and Commerce: Subcommittee on Telecommunications and Finance continued oversight hearings on television violence, with emphasis on impact on minorities on September 15, 1993.

Mr. Chairman, Representative Fields (ranking
minority leader), and members of the House Subcommittee on Telecommunications
and Finance, it is a great honor to appear before you today as the United States
Surgeon General. I commend you on your insight in addressing how television violence
affects our communities and especially our children. I appreciate the opportunity
to add my professional observations to this forum.

I attended medical school on the G.I. Bill and am now a board
certified pediatric endocrinologist. For over twenty years, I have been on the
faculty in the Department of Pediatrics at the University of Arkansas School of
Medicine. For the past five and a half years, I served as the Director of the
Arkansas Department of Health. As a result of my background, education, training,
and experience, I have become a strong advocate for programs that will strengthen
families, reduce risky behaviors, improve health and enable children to become
healthy, educated, motivated and to have hope for the future.

You have asked me to talk about the effects of violence in
the media on our communities and children. I am here today to tell you that violence
in America is a critical public health issue, deeply embedded in our society that
requires the sustained effort of not just the public health community, but also
criminal justice, education, housing, community and religious institutions --
in short, all of us committed to giving our children a safe and hopeful future.

Mr. Chairman, as your Surgeon General, I am deeply concerned
about this epidemic of violence -- and deeply committed to preventing it. Violence
breeds in every community, large and small -- and especially in pockets of poverty
where residents believe there is little hope for the future.

To understand the effect of media violence on our children
we must look at how it fits into that larger picture of violence in our society.
Violence is a very complex problem for which there are no simple solutions. The
prominence of violence in the movies, on TV, and in the news should make us all
realize how central a place violence has come to occupy in our society. The media
mirrors our culture, and we need to take a hard look into that mirror.

Our culture tends to glorify violence. Courageous alternatives,
such as talking things out and peacefully resolving conflicts, are considered
cowardly. We need to look carefully at our culture to see the many places where
these misguided values are set and conveyed, and we need to think hard about the
many ways we can go about changing these norms and values. There is no one cause
for violence; therefore, there will be no easy or simple solution.

Every year, over 23,000 U.S. citizens die by violent acts,
an average of 65 people a day. Another 6,000 people each day suffer injuries related
to violence. In 1987, America spent an estimated $19.9 billion on long-term medical
and mental health treatment, emergency response, productivity losses, and administration
of health insurance and disability payments for injuries from violent assaults.
Successful prevention means that many of these 23,000 people would be alive and
contributing to society. Prevention means saving people and society the human
suffering and financial cost of caring for the injured and the resulting disabled.

One of the factors that makes these numbers so devastating
is the youth of the victims and the perpetrators. A group of young people reported
in a recent PHS survey that violence was so prevalent in their lives they believed
they would not live to age 16. Homicide is the second leading cause of death for
those ages 15 through 24. Violence has a disproportionately greater impact on
racial and ethnic minorities. In fact, it is the leading cause of death for African
American males and females ages 15 through 24. Women are frequent victims of both
physical and sexual assault -- many of which are fatal. In 1990, 5,316 women were
murdered--six out of every ten by someone they knew.

To protect our children, there are many things we must change.
Addressing TV violence alone is not enough. We must address these "root causes."

What can public health offer in the nation's effort to stop
the epidemic of violence? First, public health can provide a scientific basis
for defining the problem and finding solutions. The topic of violence in our nation
is a very emotional one. It has all the elements of human drama--the death of
children, the glamour of the media, the right to bear arms. These issues have
placed the debate in an emotional and political framework. We need good, factual
information to make good decisions about public policy and individual and societal
choices. And the public health community can do that by gathering the data and
appropriate information on all aspects of the problem, including who is affected
and what puts people at risk. Public health also has experience with designing
interventions that address the multiple facets of the problem, and we are helping
communities put these interventions in place and evaluate their effectiveness.

Let me take a moment to summarize the data we have on media
violence. Television has become an integral part of American society with at least
one television set in 99 percent of American households (two in 66 percent). The
average American child at the time of graduation from high school has spent more
time watching TV -- 15,000 hours -- than in school -- 11,000 hours. By age 18,
the average American child has witnessed approximately 250,000 acts of violence
on TV and/or in films.

American youths identify with media characters and superheros,
especially if a same-sex role model is absent in their own life. These young people
consequently model their own behavior after these fictional personalities. Research
has shown that boys and men who are poor, urban and who have witnessed or been
victimized by violence in their families are more at risk for this kind of behavior
modeling.

Given the universality of television and the extent of time
involved in watching, there has been considerable concern about the effects, bad
and good, of television. For more than two decades, research on the effects of
television violence has been a subject for careful review and assessment by panels
of behavioral scientists:

In 1972, the Surgeon General's Scientific Advisory Committee
on Television and Social Behavior found a preliminary and tentative indication
of a causal relation between viewing violence on television and aggressive behavior;
an indication that any such causal relation operates only on some children (who
are predisposed to be aggressive); and an indication that it operates only in
some environmental contexts.

The committee also observed that "(t)he sheer amount of television
violence may be unimportant compared with such subtle matters as what the medium
says about it: is it approved or disapproved, committed by sympathetic or unsympathetic
characters, shown to be effective or not, punished or unpunished."

In 1982, the National Institute of Mental Health conducted
a review of the decade of extensive research (some 2500 titles) that followed
the Surgeon General's report. The most relevant section of the NIMH report is
as follows:

After 10 more years of research, the consensus ... is that
violence on television does lead to aggressive behavior by children and teenagers
who watch the programs. This conclusion is based on laboratory experiments and
on field studies. Not all children become aggressive, of course, but the correlations
between violence and aggression are positive. In magnitude, television violence
is as strongly correlated with aggressive behavior as any other behavioral variation
that has been measured. The research question has moved from asking whether or
not there is an effect to seeking explanations for the effect.

The NIMH report also noted the potential of and evidence for
television to affect health practices, cognitive and emotional functioning, imagination,
creativity, prosocial behavior, and socialization. Television, thus, can be a
notable influence for good as well as bad.

In 1992, the American Psychological Association published "Big
World, Small Screen," a report of a committee of psychologists that substantive
update of the literature on television effects. With benefit of ever increasing
research on the effects of violence, the APA report observes:

The accumulated research clearly demonstrates a correlation
between viewing violence and aggressive behavior -- that is, heavy viewers behave
more aggressively than light viewers. Children and adults who watch a large number
of aggressive programs also tend to hold attitudes and values that favor the use
of aggression to resolve conflict --- these correlations are solid. They remain
even when many other potential influences on viewing and aggression are controlled,
including education level, social class, aggressive attitudes, parental behavior,
and sex- role identity.

To sum up, the weight of the scientific evidence is that there
is reason for concern about the effects of media violence.

Now let me return to the role of public health in stopping
violence. In public health, we focus on primary prevention -- programs and policies
that are designed to prevent violent behaviors, injuries, and deaths from occurring
in the first place. Until recently, most of our nation's response to violence
has been to apprehend, arrest, adjudicate, and incarcerate violent offenders through
the criminal justice system. Too many today believe this response is too little,
too late. It is an expensive solution. By itself, it will not prevent the spread
of violence in America.

Although we have a great deal to learn about how to prevent
violence, we do know that violent behaviors, and the injuries and deaths that
result, can be prevented. Even those in the criminal justice system -- the police,
the judges, the probation officers and others -- are saying the same thing. We
cannot continue to wait until violence occurs to rehabilitate the offender. We
must stop the violent behavior before it starts. For example, we know that when
nurse home visitors meet with expectant parents, they can counsel them and discuss
parenting skills with the end result of decreasing the incidence of child abuse
and preventing some of the violence that might otherwise be perpetrated by youth
abused as children.

This means public health, justice and other social systems
working together. The Department is seeking ways to collaborate with other Cabinet
agencies -particularly the Departments of Justice, Education, and Housing and
Urban Development -- to find more meaningful and effective ways of confronting
this problem on a larger scale.

Public health can mobilize a broad array of existing resources
in medicine, mental health, social services, education, and substance abuse prevention
to attack injuries and death from youth violence. But, most importantly, the best
resource in preventing violence is the community itself. Public health works in
partnership with communities to design programs that fit their unique problems
and culture. The success of any program is likely to reflect the community environment
and the ownership of the program by the community.

I am now pleased to tell you about the programs we already
have in place in the Public Health Service for addressing this problem, as well
as our plans for future activities in this area.

The PHS has worked and will continue to work closely with State
and local health departments, as well as non-governmental organizations from the
community to the national level. For example, we have supported the campaign of
the American Medical Association to help physicians across the country identify,
treat, and refer patients involved in family violence. The President-elect of
the AMA, Dr. Robert McAfee, has testified before your subcommittee already; we
share his concerns in this area and plan to work closely with him. PHS is also
coordinating its efforts with other parts of the Department, including the Administration
on Children and Families.

Regarding PHS-specific efforts, since the early 1980s, our
Centers for Disease Control and Prevention (CDC) has led PHS violence prevention
activities. In addition to this leadership role, CDC sponsors and funds violence
prevention programs. CDC conducts and funds epidemiological studies of violence,
collects trend data, researches the risk factors associated with violence, supports
community demonstrations of interventions (such as conflict resolution, school
based educational curricula, mentoring), and funds evaluations of interventions
and training.

Other PHS agencies also make important contributions to the
Department's violence prevention goals. Programs of the Substance Abuse and Mental
Health Services Administration (SAMHSA) work to prevent and treat two significant
cofactors of violence, substance abuse and mental illness. The Office of Minority
Health (OMH) funds grants for coalition building and other community-based activities,
including violence prevention, targeted at minority males. The Maternal and Child
Health Bureau (MCHB) of the Health Resources and Services Administration (HRSA)
supports demonstrations to evaluate methods of reducing violence among children
and youth, child abuse, and dating violence.

The President's FY 94 budget includes proposals for new violence
prevention projects in two PHS agencies:

A $10 million increase for CDC for an initiative to prevent
violence against women.

A $5 million increase for the Center for Substance Abuse Prevention,
part of SAMHSA, to target substance abuse prevention to youth at high risk for
violent or anti-social behavior.

I hope that this brief overview of the problem of violence
in our country helps you place the issue of violence in the media in perspective
with all the other issues related to violence prevention. In your deliberations
on the impact of media violence on violent behavior, I hope you will not forget
the critically important role of media in preventing violence. Recent successes
with public health information and education campaigns for smoking reduction,
cardiovascular disease reduction, and AIDS prevention suggest that similar efforts
can be important parts of the public health approach to violence prevention. With
violence prevention, it is clear: children learn from watching television, and
what they learn depends on what they watch. The programs they see on television
change their behavior. If they look at violent or aggressive programs, they tend
to become more aggressive and disobedient. But if they look at prosocial programs,
they will more likely become more generous, friendly, and self-controlled.

Violence prevention messages can be included in public service
announcements and information programs, in entertainment programs, and in news
features. To achieve the same success as has been achieved with anti-smoking efforts
for example, public health information campaigns for violence prevention need
to formulate precise objectives, identify target audiences, carefully develop
culturally competent messages, and then measure the impact of these marketing
efforts.

We hope to work with the media to do the following:

First, help to shift the violence prevention paradigm from
a focus now limited to only helping victims of violence and changing perpetrators
of violence, to one that includes preventing violence before it ever occurs.

Second, make people aware of the magnitude and characteristics
of the problem of violence today by describing the many forms violence takes across
the span of life: child abuse, child sexual abuse, youth violence, gang violence,
hate crimes, domestic violence, sexual assault, elder abuse.

Third, let people know that violence is a preventable problem
and that, as parents and citizens, we all share in the responsibility to change
it.

Fourth, give hope to individuals and communities, informing
them that there are things that work to prevent violence, there are things that
people and communities can do to prevent it.

Fifth, mobilize individuals, organizations,, and communities
to act.

Sixth, provide information about what works and how to conduct
effective prevention programs.

We also need to look at how news media portrays violence, and
how they could better promote understanding of the impact, causes, and solutions.
Media could promote better understanding among diverse groups, family members,
and racial/ethnic minorities. And TV can publicize those community resources that
are available (e.g. boys and girls clubs).

Parents and teachers must help children put violence in the
media in perspective. Today, the average child ages 2-11 watches 28 hours of TV
each week! We must realize the extent to which we have abandoned our children
to TV. We need to reclaim them, we need to spend time with them, do things with
them and teach them the values we think they need to have. In those communities
where traditional family and community structures have broken down, we need to
rebuild them.

It will take the strengths and positive values of our communities
to turn this problem around. We must make our homes, our communities, and our
nation safer. As a public health official, I have learned that, before you can
increase resources to treat a problem, you must convince the masses that a problem
exists. In this case, the best treatment is prevention. Prevention must start
early, with our children.

I welcome the opportunity to work with you to increase awareness
that violence is a public health problem. Together, I hope we will be successful
in making our streets and our homes safe again.

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